Publishing their findings in the Annals of Epidemiology, researchers analyzed HIV diagnosis rates in 49 states plus the District of Columbia from 2010 to 2015 according to Centers for Disease Control and Prevention (CDC) records. They also looked at 2010 to 2012 rates of intimate partner violence reported to the National Intimate Partner and Sexual Violence Survey—which is overseen by the CDC—in these jurisdictions.

The researchers scored the intimate partner violence policies of state health care systems on training, screening, mandated reporting, specific protocols and whether they prohibited insurers from raising premiums or denying health coverage to individuals with a history of intimate partner violence.

Diagnosis rates were higher among women in states that scored lower on these criteria.

“These results strengthen the argument that HIV is associated with intimate partner violence and the data shows this association is not isolated to a few specific areas but a problem across the United States,” Tiara Willie, PhD, the study’s lead author who recently earned her doctorate from the Yale School of Public Health, said in a press release. “It is our hope that state policymakers will see that IPV policies are effective and will implement more policies that address HIV prevention for women in abusive relationships.”